Just over two years ago at the first United Nations High-Level Meeting (HLM) on Tuberculosis (TB), no one could have predicted we would now be in the midst of a global pandemic, which will undoubtedly have an effect on the targets set out in the Political Declaration. With goals of treating 40 million people with TB, 3.5 million children with TB, 1.5 million people with drug-resistant TB, and putting at least 30 million people in TB preventative treatment, all by 2022, is the world on track?
Opened by Tereza Kasaeva Director of the Global Tuberculosis Programme at the World Health Organization, this session used the recently released 2020 Global TB Report to examine our progress to date and evaluate the challenges we still face in the years ahead. As Dr Kasaeva outlined, in many ways we are still falling quite short of the End TB targets in a number of key areas: From 2015 to 2019, we only saw a 9% reduction in incidence compared to the targeted 20%, a 14% reduction in deaths, well shy of the 35% target, and still more than half of all people with TB are facing catastrophic costs, despite a goal of reaching zero.
As for the HLM targets, Dr Kasaeva reported that for four key targets of treatment, preventative treatment, research and funding, we are still falling behind, particularly for funding, but that the current pandemic also presents us with an opportunity: “We can see that, especially looking at the current situation with fundraising for COVID-19, that it is possible and it means that we should strengthen our advocacy and do more.”
The HLM brought a level of awareness of TB to political leaders that many of them hadn’t been exposed to before, and further emphasised the importance of political will in the fight against TB. The Honourable Dr Angelina “Helen” Tan, member of the Global TB Caucus and co-chair of the Asia Pacific TB Caucus spoke to some of the successes and challenges of driving country-level political commitments for health, including a landmark law amendment creating a framework for private sector participation in funding the national TB elimination programme that she has introduced in the Philippines.
One of the biggest concerns both leading up to and after the HLM was how countries would be held accountable to the targets they agreed to, and also how that accountability would be tracked and by whom. Tushar Nair of the Global TB Caucus co-Chairs the Global Accountability Platform, a group of civil society organisations dedicated to ensuring that the accountability process being led by the WHO is fully transparent and has strong, inclusive, representative and connected review mechanisms and fora at all levels – global, regional, national and subnational, and built around 3 pillars of actions, monitoring and reporting and review. “Once we know where accountability stands, then we know how to improve, and where to target improvements.”
Closing the session and highlighting the specific importance of the HLM targets for affected communities was Blessina Kumar, CEO of the Global Coalition of TB Activists (GCTA). “Communities can actually bring that unique perspective that nobody else can bring, and can bring real data from the last mile recipients. Because communities are everywhere: National TB Programmes, Ministries of Health, even technical agencies like WHO, like Stop TB Partnership have repeatedly said ‘we are dependent on you – the communities – to give us the information.’”
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